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Review of New Books*
Department of Reviews and Abstracts J<}m'l'ED BY
J,oms lVI.
JlELL:\IAN,
M.D.,
BROOKLYK,
N.Y.
Review of New Books* B~· C+eorge .1'.'. Papanicolaou, M.D., Ph.Jl. 176 page~ with Cambridge, Mass., 1!1.54 1 Harvard Cniversity Pre~s. $18.00.
Atlas of Exfoliative Cytology, SJ illustrationH.
'l'he increase in the knowledge of exfoliative eytology has to a large degree bHen due to the investigations of llr. Papanicolaou and therefore appeara nee of a new book by him is greeted with enthusiasm.
This latest book is published in n tmi•1ue style. It is a looseleaf manuscript with large rings so the pages do not bind and eonsequentl.v have little tendency to tear. This method of publication allows for additions in the future. 'rhe softness of the binder. however, is not conduei ve to wear and tear. '!'his may he au objei•tion if the hook is used frequently without due car•'· Exfoliative cytology has been most frequently applied to the study of the female genital tract but other body fluids are amenable to this method of study. 'l'!tiR" book deals with most of such fluids, including the methods of obtaining them and the techniques of fixing aiHl staining. The study of the t)·tolog.v of the systems of the hody other than the female genital tract i~ in its infancy and Jlr. Papanicolaou rightly empha~izcs that mueh ha~ to he learned. The coloretl plates are excellent and their descriptions although brief are adequate. i~ ahlc> to nmwve a plt1te and P.ompare it enRily with an~· other plate or (]e~cription.
Because of the looseleaf arrangement, one
It appearR .from the text that mruty abnormal cells which previously had been interpreted as suspiei0118 of malignancy now are con~idered abnormal but HOt necessarily itulic~ati\·e of malignancy. Tl1is iH in ke,ping with the thought of must workt>rs in this llPls frequl'nth proflu('e bizarre rells that ean lw mi~intr~rpreted h\· the inexperiencwl pt>rsm1. Our aspt'llt of exfoliative cytology of the female genital tract is not ineluderl and yet ma,Y hr· most important, namely, the vaginal eytolog.1· of the prepubertal girl in health and disease. Cytolog:· at that time of life may he ver:· useful in the fliaguosis of rJ~
'rhis latPst work of Dr. Papanicolaou is very worth while ancl should find a wide demanrl. It can he highl:· recomrnender1. t>~p~dall~· a~ a rcferenre book.
Chronic Iliac Pain in Women. Springfip](], 111.. Hi54,
(~hnrle~
lly H. B. At!ef;, M.n.
li:'i
pages with H
illuHtration~.
C Tlwrnas. $2.50.
'.!'his hook i~ a short, easily read monograph Hummariziug the main eauRes of chronie iliac pain. '!'he hook i~ rlividerl into nine ""·tions in which f]ifferent (tisorder~, such as ehronic appendicitis and painful ovary are deseriherl briefly-. The hook, while rlescri bing a serious problem, is writtAn in a humorou~ n>in. l!'or example, in t'!elldihing the ~o-~alled "r.('<~al syn.lrome"- "~ome pPople feel that if thr"ir lwwds •lo 110t move torla,v, the :,ltom *TIH• .\dvi"ory Committee on Poliey ha" agrefltl that most book reviews need· not be ~igne
Volume 68
Number 3
BOOK REVIEWS
!151
bomb will fall tomorrow, and harassed by this fear, they do everything to whip their poor bowels into action every morning except to relax on the toilet seat long enough to give them a chance to empty themselves on their own." The main premise of the book is that surgery should be performed for chronic iliac pain only if a definite diagnosis is made. Otherwise patients will be subjected to neerlless surgery, and still retain their pain. Because of the message it carries, young gynecologists and general surgeons would do well to read this book. Les Groupes sanguins chez l'homme. :Etude serologique et genetique. By Jacy_ues Huffie, Assistant Professor, Legal and Occupational Medicine, University of Toulouse. 212 pages. Paris, 1953, Masson & Cie. 1.200 fr. The universal practice of blood transfusion, the problems of fetomaternal immunization, and a variety of medicolegal questions, make the subjects of blood groups one of great practical and theoretical importance. Dr. Ruffie's book is a detailed account of the basic information available on this vast subject. The four major blood groups, the Hhesus, Lewis, MNSs, PQ, and seven other minor systems are examined, and the genetic aspects, statistical analysis, and clinical importance of each are thoroughly discussed. A general introductory chapter on immunization phenomena of the Llood is outstandingly dear and will be of value to anybody who is not particularly well acquainted with these matters. The book contains a discussion of "some elementary principles of the statistics of probability" which is not at all elementary but will help the reader to understand the statistical analysis of each system. When a fundamental problem is discussed, the author gives an ample resume of the major theories involved, such as those of Hirszfeld, Morgan and Watkins, Boorman, Doild, and Gilbey, on the H antigen. · The bibliography is extensive and up to date. The reader will not find here any original contribution, Lut he will benefit from the clarity with which the subject is treated. Lehrbuch der Geburtshilfe. Edited by Prof. Dr. Th. Koller, Basel, Prof. Dr. E. Held, Zurich, and Pro£. Dr. W. Neuweiler, Bern, Switzerland. Second edition. 851 pages with 348 illustrations. Basel, 1953, S. Karger Verlag. Swiss francs 62.40. This volume constitutes the second part of a three-volume text on obstetrics and gynecology. Consequently, it does not embody any description of obstetrical procedures, which are reserved to the third volume. The book is very 'Yell arranged. It contains sections on embryology, normal pregnancy, normal delivery and puerperium, the physiology of the newborn, multiple pregnancy, the pathology of pregnancy, extrauterine gestation, abnormal delivery, complications of the puerperium, monstrosities, and the pathology of the newborn. Each of the different sections has been written by an authority in his field. Altogether, this constitutes a most impressive textbook. The sections on monstrosities and fetal pathology are especially good. These subjects are much more fully covered than is customary in obstetric texts. Roentgen pelvimetry receives scant consideration. The classification of contracted pelvis is based upon etiological factors, rather than morphology. A low-protein diet is advocated in toxemia. Curettage is not performed in incomplete abortion unless all other measures have failed. One of the illustrations in the section on infant resuscitation shows jackknifing of the infant as a means of artificial respiration. With these, as well as some other features, the reviewer would take issue. However, with due allowance for differences in opinion, this remains a thoroug·h ant1 scholarly survey of the field of obstetrics. It may be highly recommended.
952
Am. j. Obst. & Gynec. SePtember, 1954
BOOK REVIEWS
Handbook of Gynaecological Diagnosis. By Walter Neuweiler, M.D., Professor of Midwifery and Gynaecology and Director of the Gynaecological and Obstetrical Clinic in the University of Berne. 4±8 pages with 406 illustrations. New York, 1H52, Grune & 'Stratton. $12.00. As stated in the author's preface, this book is merely a supplement to the many recognized textbooks in gynecology. If the reader will bear this in mind, he will find it of extreme interest. 1'he methods of obtaining a complete gynecological history are aptly explained. They are further enhanced by a careful consideration of such things as constitutional types and symptom complexes. The techniques of performing and interpreting various gynecological examinations are lucidly portrayed and describecl. The section on hysterosalpingography is especially well illustrated. Although the importance of colposcopy in the diagnosis of cervical malignancies is stressed, it is unfortunate that little mention is made of the value or significance of the Papanicolaou smear. Furthermore, in the description and illustration of the lymphatic spread of cervical carcinoma, there is no inclusion of the obturator lymph nodes. In view of the accepted practice of early ambulation in elinics in this country it is interest· ing to read the author's statement that following a uterine curettage the patient "neens at least two to three days' rest in bed." 'fhe author is to be commended for the careful organization of his m~terial and the excellent illustrations. Just as previous texts on differential diagnosis in other branches of medicine have been of value, the Handbook of Gynaecological Dia.gnosis should be a useful guide not only to the medical student but also to the practicing physician in the field of gynecology.
Die Kreuzschmerzen der Frau, Ihre Deutung und Behandlung gynaekologische Orthopaedie. By Dr. Heinrich Martius, Gottingen, Germany. Ji'ourth Improved Edition. 166 pages with 73 black and white illustrations. Stuttgart, 1953, Georg Thieme. DM 19.50. This book covers the twilight zone between gynecology and orthopedics in the very difficult field of low back pain. It is divided into two sections. The first deals with low back pain in women, caused by diseases of the viscera of the true pelvis. The second, and larger portion, concerns itself with low back pain due to changes in the skeleton, the local musculature, and even such culturally determined factors as high heels. The author emphasizes the importance of accurate etiological diagnosis preceding therapeutic intervention and the pitfalls of attempting treatment without adequate diagnosis. Both diagnostic and therapeutic procedures are explained. It is pointed out that the erect posture of man and easy childbirth are opposed to each other and that the skeleton of the human female represents a balance between the two which is easily upset. This volume covers very adequately a field which is of constant interest to the gynecologist and it is well worth his attention.
The Nursing Mother. By Frank H. Richardson, M.D. Prentice-Hall, Inc. $2.95.
204 pages.
New York, 1953,
This small volume is written primarily for the pregnant woman. Although it cannot be denied that breast feeding is to be preferred to bottle feeding, the woman who does not breast feed her infant for any reason should not be condemned to the point whe1·e marked psychological disturbance is produced. This book might well cause this undesired result even though the author occasionally attempts to prevent it. The section devoted to proving that the breast is better than the bottle for feeding infants is not grounded on very good scientific evidence. Infant death rates of one era should not be compared with those of another era unless all factors, not just one such as breast feeding, are considered. The evidence presented is from work done twenty-five to thirty years ago. Inquiry by the reviewer of leading authorities in the field of pediatrics disclosed there are no current authoritative studies that show any difference between the infant mortality rates of bottle-fed and breast-fed infants. There is a higher incidence
Volume 68
Number 3
BOOK REVIEWS
of gastrointestinal disturbances in the secon(l six months of life in the bottle-fed group. The statement that facial development is better in the breast-fed infant than in the bottle-fed infant will be received with skepticism. The author pictures the bottle-fed baby as disregarded by his mother, fed b~- a stranger in strange surroundings, and doomed to permanent psychiatric aberrations. This is by no means a usual occurrence and should provoke some righteous indignation. There are many places in the book where scientific logic is not sound. It is stated that therapeutic abortion is done to save the life of a woman, but then the author states, "Such an interference with nature is attended with more danger than would have been risked had the woman gone on to a full-term delivery.'' Several quotations are given but rarely is the name of the author of the quotation mentioned. Not only is this poor taste, but it also deprives the reader of the authority for the quotation. It is unfortunate that in a book of this type so much emphasis is plared on "natural childbirth," for this might tend to disrupt the relationship between patient and obstetrician if the latter is not an enthusiast for this form of labor. A book of this type is needed in American medical literature to point out the advantages of breast feeding but the criticisms mentioned illustrate weaknesses which may limit its usefulness.
La Sterilita nel maschio. By Guglielmo Longo. 520 pages with 87 illustrations. Naples, 1953, Diffusion Scientiiique Internationale. By far the greatest part (eight-tenths) of the work is dedicated to the normal anatomy and .physiology of the male genital system and to a classification of the various forms of sterility. There is a very exhaustive chapter on clinical and laboratory techniques which includes all the tests more commonly used in the United Statrs and many tests which are rarely used. Therapy is dealt with in one and the smallest chapter, and it is subdivided into: A. 'rreatment of the deficieneies of eoitus; these may be treated according to the etiology of the speciiic case, by (1) hormones, (2) electroshock, electrical cauterization of the nasal mucosa, (3) iniiltration of the hypogastric ganglion and similar procedures, ( 4) psychotherapy (but psychoanalysis is considered "not useful"). B. Treatment of obstructions of the seminal tract; these demand surgical treatment. C. Treatment of the disturbances of spermatogenesis; hypogonadism (deficiency of both the endocrine and the spermatogenic functions) may respond to treatment with gonadotropin. The ability of testosterone to inerease spermatogenesis is open to debate; it has a more deiinite effect in re-establishing the motility of spermatozoa. Dr. Longo's work is essentially a recapitulation of the basic known facts about male sterility. While there is no original contribution to the understanding of the causes, nor any statistical observation sufficiently large to attract attention, the available material has been examined thoroughly and is clearly presented.
Annual Report on the Results of Treatment in Carcinoma of the Uterus, vol. 8. Edited by James Heyman, Stockholm, Sweden. 247 pages.
Stockholm, 1953, Norstedt & Son.
This is the eighth volume of a valuable publication issued approximately annually, and sponsored by The American Caneer Society, The British Empire Campaign, and other prominent institutions concerned with the cancer problem. '!'he editor of the series is Dr. James Heyman of Stockholm, and the plan of each volume is to summarize reports treatment of carcinoma of the female genital tract. Previously, carcinoma of the cervix from leading institutions throughout the western world on the subject of the results of has been the only female genital cancer speciiically reported, and irradiation has been the only method of therapy considered. The scope has iinally been extended in the present report to include carcinoma of the endometrium, and apparently the intention of the future editions is to include summaries dealing with ovarian carcinoma.
954
BOOK H r;V 1E\Y:-;
I Ul"' ,, I Sept~·rni,,,t,
Tho btltt.i,;tie,; J•l'eseuJ<:d in tliio< l'•>lttJr:t 1\ •·rtt l'ulledetl J'n!!u 1;\1 dift'l't(·nt i:;bi i:>:l ,,>tL··, 1:.: of whidt arn ltH·att'd i11 tili:-.. ('Utlutr.'. FJfil'i.'lt difl't•J't'H( t''J!Jfltrit~:-~ un). n·pn·;~P!l!P•i. Tl1,. l'eoultc; L'()VCl' n. total of s:;,:.wJ "/Hit'S of ui•·t'u.: "aremoma. Tltt!J't'iUt··l preliminary e8says un ,;uelt tupic~ as tlie tlesirability uf impruved {acili!it:s i'•.Jr ol,tail!ing rules for t•oHal>oratur,; wheu rt•porting "" caHes ,,r 1>.011 reliable therapeutic !Ito t'tnJ<[u,, invasive carcinoma, ~peeial pwblems n•latiu:,; It• statenwuts •lit •:luein<>UHt and a careful statement. of staging critHritt. 'l'he editorial <)••mmittee ltas hePH <'IIlii· mendably zealous in attt•utpting to attaill the ideal of absolutely uniform nitt•ria f<>r elinical clas~ificatioH uf ca~<'S of gunita! •·anver to l'<'l'ltlit •·utnparnt'in: entluation pf statistics. The preoJeJtt lic eon,in hiups\ •'n ul>taitrt'd. Obviously, this publieation mu~t l1e iu til•• n•frn•u<'t' tilt> ::!' illl dl']Htl'llw•nts ir••atiugvatients with female genital (•areinoma..
Honnonal Control of the Pelvic Girdle and Sexual Endocrinology.
Hy Mamiee l\larois.
176 pages with J 2 plates. PariB, Hl53, l\[asson & Cie. $2.5!i. An elaborate and comprehensive monogt·aph covering all aspec!B of the problelll of the hypothetical hormone, relaxin, whielt is postulatNl t.u l><: responsible for polvie relaxation in various species has been wJitten by the eodir;;etor of the Laboratory of Experimental Morphology anrl Endocrinolugy of the College of France. The ~tartiug point of this elaborate book iH an exalllination of Hi8aw 's hypothesis that symphyoeal separation in the guinea pig is due to an unidentified hormone, relaxin. Professor Courrier, director of the Laborator:v of Experiment ul 1\lorphology and En,locrinology at the College of ]'ranee, has believed for some time thai. relaxin i~ not :1 ~pedfic substanee, silH>e H is possible to produce s•·paration of the pnl>i<' i>Olll'K in a etn.:trat••!ll\1 awl ul' progeHterone, This hor· moue combination is not efl'eeth·e when the utfwus i8 abs<'nt: and the id•~a tlmt there is a specific uterine lwmtOIHl is raised. ThiK n•oJJOgraph attempts to nwiew very eompre· hensively all the literatme on the snb;i••d, and to report the results of Maroi~' own investigations. After performing extensive experinlPntal studies in Ow guinea pig, the author has reached several interesting eonclusions. HH was able to eoniinn that the use of estradiol and progesterone as mutual synergists produces ~ymphysal separation onl,Y when some uterine tissue i~ left in tho animaL OnlJ· a small amount of uterine tissue is necessary for the mediation of thiB eJTect. If hyHtereetomy is performefl in animals who have appreciable symphyseal separation, syr11physeal closure iB producetl, without reference to the doses of estradiol an•l progesterou•• administered after thll proe<'erirnentally hysterectomized animals.
Volume 68
Number 3
BOOK RE'VIEWS
!!55
A great many pages of the monograph are devoted to the tentative exploration of several avenues of approach to the identification of a specific hormone capable of producing symphyseal ligamentary relaxation in the guinea pig. Marois is frank to admit that he has not been able to solve this problem satisfactorily. He has confirmed previous observations that extracts of corpus luteum are capable of producing pubic symphyseal relaxation in the female guinea pig very much more readily than the synergistic action of follicular hormones and progesterone. But the confirmation of the well-known fact that symphyseal relaxation may be produced in these various ways has not been established beyond reasonable doubt, since this would involve the isolation and purification of whatever specific agent is responsible for these hormonal interactions. The major obstacle remains the lack of reliable, eritical biologic tests for assaying the activity of tissue extracts. In summary, this massive monograph, virtually encyclopedic in approach, broadly speculative and imaginatively presented, represents a stocktaking of the present state of our ignorance on this much debated subject. In :Marois' own words: "In spite of the extent of the data already acquired, we are left with more darkness than light. It is hoped that this work will constitute an invitation to further research." Only an elementary knowledge of French syntax is necessary for the reading of Marois' elegantly clear style, a model of its kind. The carefully compiled bibliography makes the monograph an essential item for the library of all investigators of these problems. Le Pneumopatic sufethine del feto e del neonato. By Guiseppe Valle. 54 illustrations. Torino, Italy, 1953, :Minerva Medica.
209 pages with
Dr. Vulle is the director of the Clinic of Obstetrics and Gynecology at the University of Perugia in Italy. In this book he presents an extensive review of the literature relating to pneumonic infections in the fetus and the newborn. In a careful, organized, and scholarly rr_anner he correlates all of this material with his own observations and researches. 'I'here is a complete and exhaustive bibliography. The book is arranged in ten chapters: The first chapter is a historical introduction of the sub;iect. The second chapter deals with classification of the pneumopathias. He proposes his own scheme which divides the sub,iect into three main periods: prenatal, intranatal, and neonatal. These are further broken down into smaller subdivisions with regard to tbe causative agents involved. Subsequent chapters deal chiefly with etiology and pathogenesis. There is an interesting discussion as to the routes infection may take to cause pneumopathia in the fetus, and these are clearly illustrated with diagrams and sketch drawings. Many charts are presented reviewing the organisms involved and the problem of placental transmission. The importance of the aspiration of amniotic fluid by the fetus upon birth, is emphasized, particularly if the membranes were prematurely ruptured and the amniotic fluid infected. The book offers no unusual new theories or solutions, It does, however, serve several important functions. First, it is a good review of the subject matter; second, it suggests several good research problems; third, it alerts the obstetrician to the fact that he is always dealing with two patients, mother and fetus, and that he is responsible for the course and welfare of both; and last, it urges the pediatrician to be more cognizant of the pre-, intra-, and neonatal periods of the infant, so that ultimately his attention may be more effective. Seventy-Five Years of Medical Progress, 1878-1953. Edited by Louis II. Bauer, M.D. 286 pages. Philadelphia, 1954, Lea & Febiger. $4.00. This enlightening book followed the First Western Hemisphere Conference of 'rhe World Medical Association, which was held in Richmond, Virginia, in April, 1953. The object of this conference was to recall the medical progress which has been attained during
956
BOOK REVIEWS
Am.
J. Obst. & Gynec.
September, 195+
the past seventy-five years. The papers were contributed by our most distinguished colleagues in the field of medicine and in the different medical specialties. Each author has endeavored to give a brief review of the history and the distinctive events in his field and to appraise these achievements. It is interesting to obtain this retrospective view of how the various specialties have developed and have become defined. The present extent of our knowledge is also reviewed. The text has not neglected the field of general practice, its role in past progress, and the irnportanee of the general practitioner as a central figure in the care of patients. The book is refreshing as it makes the reader cognizant of the primitive status of medical practice which existed seventy-five years ago. It is thus that we realize that the time, effort, and cost of our present medical organization are well worth while. Pelvic Relaxations and Herniations. By James Wilson, M.D. 64 pages with 35 illustra· tions. Springfield, Ill., 1!l54, Charles C Thomas. $2.75. In this monograph for the American Lecture AerieR, the author points out that the work is designed for students. It first covers the clinical anatomy of the normal female pelvis and then goes on to outline the most important of the pelvic. fascial relaxations and herniations. The etiology of each is considered from an anatomical and physiological viewpoint. No attempt is made to explain in detail the technique of operative procedures but rather the general principles employed are discussed. Adequate reference to the standard operative pro· cedures for each condition is given at the end of each chapter, The work is supplemented with excellent diagrams and drawings which assist in a more complete comprehension of the text. The monograph is concise and complete in its coverage of the pelvic fascial planes and their pathology. Rh-Hr Blood Types. Applications in Clinical and Legal Medicine .and Anthropology. By Alexander S. Wiener, M.D. 763 pages. New York, 1954, Grune & Stratton. $11.50. An Rh-Hr Syllabus. The Types and Their Applications. By Alexander S. Wiener, M.D. 82 pages with 8 illustrations. New York, 1954, Grune & Stratton. $3. 75. Dr. Alexander Wiener, who has long been known as an authority on immunology, particularly in the field of isoimmunization, has written two books on the subject of Rh-Hr blood types. The first is a large compilation of some of the author's most representative and important contributions to the subject. This serves the purpose of placing these documents in one volume with an adequate index of both subject and author. For reasons not clearly discernible the author's total bibliography is also appended. Such a collection of reprints contains much valuable material. All of this is readily available in any good medical library, however, and unfortunately, when conglutinated in this manner, the bias and, at times, uncertain temper of the author are only emphasized rather than tempered with the sound and solid contemplation and revision and revaluation so necessary to fine scientific book writing. It is thus that there is a perpetuation of certain ideas which might be proper for scientific articles of the moment but which on second thought, to ~ay the least, do not come under the heading of proved fact. In such categories are the author's concept of the dual valence of antibodies, his diagrams of the cogwheel characteristics of antibody-antigen reaction, an
\ olume 68 ~umber3
BOOK REVIEWS
!)57
The second volume is a small outline of 82 pages containing a brief but accurate abstraction of much of what is contained in the first volume. Although the errors and bias are still apparent, this volume makes good reading and, if absorbed, will give the reader an intelligent background for further investigation. The article~ in the first volume have been reproduced in a format similar to the ones in which they appeared. 'rhis not only makes for variation in form throughout but in some instances because of the reduction in page size makes for unnecessarily and nearly unreadable type. The paper of this volume is poor. The type and format of the second volume, in contrast, are good throughout. In summary, it is difficult to commend the first of these two works. 'l'he Rh problem, as such, ha.s been overemphasized because of its clinical significance. In reality it differs neither in complexity nor in concept from the entire problem of erythrocyte antigenicity. On this a broad text soundly and judiciously conceived would have been more to the point.
Obstetrical Pathology. By Dr. Jose Botella Llusia. (j\J!:J pages with 434 illustrationH. Madrid, 1953, Cientrifico-Medica. Dr. Jose Botella Llusia is Professor of Obstetrics and Gynecology at the University of Medicine in Madrid. He has written and published four books, which comprise his complete course in the elements of obstetrics and gynecology, of which this title is one. The other three books are entitled Female Physiology, Obstetrics, and Diseases of the Female Tract. The book is divided into three main parts: the pathology of pregnancy, the pathology of parturition, and the pathology of the puerperium. These are further subdivided into 40 chapters, which cover comprehensively all the subjects of pathological significance relating to the subject of obstetrics. 'rhe book is unique in that it is a wellorganized and convenient text dealing only with obstetrical pathology. Most of the subjects are dealt with at great length and in great detail. '!'he 434 illustrations consist of diagrammatic sketches, photographs, and color photomicrographs. In general, the author's theories and teachings are in agreement with the universally aecepted ones. In discussing the toxemias, the author rejects the classification of pre-eclampsia and eclampsia as two separate diseases. He firmly believes they are one and the same, varying only in intensity and severity. He remarks on the apparent declining incidence of the disease in Spain, and relates this to better prenatal care and better nutrition. His preferred plan of treatment is as follows: morphine sedation, inhalation of 5 per cent oxygen with 20 per cent carbon dioxide, administration of hypertonic glucose and intramuscular magnesium sulfate. The author's comprehensive discussion of all the complications of pregnancy includes, besides the usually discussed ones, various liver dysfunctions, cholecystitis and cholelithiasis, appendicitis, mouth lesions, hernias, dyspepia, peptic ulcers, and intestinal colic. Many of Dr. Llusia's statements are quite positive, indeed interesting, although there is a definite lack of reference support. For instance, he says that gastric ulcer is rare in pregnant patients for three reasons: ( 1) there is less gastric acidity; ( 2) elevation of the stomach by the pregnant uterus lessens its distention and better vascular circulation results; ( 3) the increased estrogen enhances better healing of the gastric mucosa. The subject of cardiac complications is dealt with extensively. It is his opinion that repeated pregnancies in a cardiac patient, if well handled, do not affect deleteriously the cardiac status, general health, and longevity of the patient. The subject of abortion is thoroughly discussed along with the problem of criminal abortion. The author speculates that there are 50,000 criminal abortions performed annually in Spain. In the Madrid Maternity Hospital there were 18,000 babies born in the years from 1939 to Hl49, and 4,800 abortions. The author assumes that 10 per cent of all births should result in spontaneous abortion and that the remainder would be criminally induced. The mortality rate for abortions in this period was 3.6 per cent. G~nital
Mn.
J. Obst. & < Sept·.~n:~)k',_
The subject of dysioci:t i,; parti<·ularly 11c'!l organized nud \'.ompletely •.:<>V<.'n•d. The hook has no bi!Jiiograph;y. The lad, nl' hihliography awl. ref.,l'<'ll<'"' ii111.l ri"· :t.r·Jac· of loo$e r(·asonil'>llt :ltHJ :1\:-ll'I.Wi III•'•JI!':I: ~tudent" with tilt' :l'lll:\],J"I<'Iri·
Books Received 'l'he following books have been n'''eivt!d and select,;d roviews will appear in !att•r issues. rrFCLE
PUBLISHER
d Caneer Ginecologieo
Juan Carluo; Ahumada ( 'olaborfldor<'~
y
1<:1 Ateneo, Buenos Ain's
'fhe Digestive Tract in Roent· genology i::lccond edition
,J. B. Lippincott Co., Phila· <1elphia. $30.00
Grundlagen und Ergebenissc dcr Bulfonamidanwendung gegen Karzinomstreptokok ken
Ueorg 'l'hi;•me, DM 21
The Hypertensive Disorders of Pregnancy
Ernest Pag"
Hesuscitatiou of the Newborn
.T oscph
Crtncer of the Female Genital 'l'ract
Herbert F. Traut and Ralph
Erythroblastosis Fetalis, Re· port of the Sevt'nth M & H Pediatric Research Confer·
Charl(lS .Janeway, Chairman
Charles C Thomas, Spring· field, Ill.
C.
Rus~
Leipzig.
$3.75
Charles C 'l'homas, Spring· field .• Ill. $2.50 Davi~,
Bf'n~on
Delaney, lne., New
York
!\I & H Laboratories, Colnm· lou~,
Ohio
enee
:\I('uorrhalgia· Menstrual tress
i ~harles
Proceedings of the Society for the Study of Fertilit~· Nnmher V, HJ5:!
IV.
'l'he Intimate Women
ProhlPm~
C Thomas, Spring· $2.75
field, lll.
of
lleffer
&
<~ambridge,
Henry B. Hafford
Hawthorne
NPw Ymk
Sons, Lt1L, England
Books, $!1.95
Die Variationsmoglichkeiten im Aufbau der Uterusschleimhaut in den einzelnen Phasen des Mensuellen
Heinz Behrens
Georg 'l'hieme.
A la Hecherche cl'une ethiqne m(>dicale
Louis Port<'s
Ma~Hon
Din Viruskrankheiten in der Gyniikologie und Geburt·
Meta Sander
shilfe
OM 9.60
& C:ie, PariR.
fr. Georg Thieme
Ine.,
800
J,oms lVI.
JlELL:\IAN,
M.D.,
BROOKLYK,
N.Y.
Review of New Books* B~· C+eorge .1'.'. Papanicolaou, M.D., Ph.Jl. 176 page~ with Cambridge, Mass., 1!1.54 1 Harvard Cniversity Pre~s. $18.00.
Atlas of Exfoliative Cytology, SJ illustrationH.
'l'he increase in the knowledge of exfoliative eytology has to a large degree bHen due to the investigations of llr. Papanicolaou and therefore appeara nee of a new book by him is greeted with enthusiasm.
This latest book is published in n tmi•1ue style. It is a looseleaf manuscript with large rings so the pages do not bind and eonsequentl.v have little tendency to tear. This method of publication allows for additions in the future. 'rhe softness of the binder. however, is not conduei ve to wear and tear. '!'his may he au objei•tion if the hook is used frequently without due car•'· Exfoliative cytology has been most frequently applied to the study of the female genital tract but other body fluids are amenable to this method of study. 'l'!tiR" book deals with most of such fluids, including the methods of obtaining them and the techniques of fixing aiHl staining. The study of the t)·tolog.v of the systems of the hody other than the female genital tract i~ in its infancy and Jlr. Papanicolaou rightly empha~izcs that mueh ha~ to he learned. The coloretl plates are excellent and their descriptions although brief are adequate. i~ ahlc> to nmwve a plt1te and P.ompare it enRily with an~· other plate or (]e~cription.
Because of the looseleaf arrangement, one
It appearR .from the text that mruty abnormal cells which previously had been interpreted as suspiei0118 of malignancy now are con~idered abnormal but HOt necessarily itulic~ati\·e of malignancy. Tl1is iH in ke,ping with the thought of must workt>rs in this llPl
'rhis latPst work of Dr. Papanicolaou is very worth while ancl should find a wide demanrl. It can he highl:· recomrnender1. t>~p~dall~· a~ a rcferenre book.
Chronic Iliac Pain in Women. Springfip](], 111.. Hi54,
(~hnrle~
lly H. B. At!ef;, M.n.
li:'i
pages with H
illuHtration~.
C Tlwrnas. $2.50.
'.!'his hook i~ a short, easily read monograph Hummariziug the main eauRes of chronie iliac pain. '!'he hook i~ rlividerl into nine ""·tions in which f]ifferent (tisorder~, such as ehronic appendicitis and painful ovary are deseriherl briefly-. The hook, while rlescri bing a serious problem, is writtAn in a humorou~ n>in. l!'or example, in t'!elldihing the ~o-~alled "r.('<~al syn.lrome"- "~ome pPople feel that if thr"ir lwwds •lo 110t move torla,v, the :,ltom *TIH• .\dvi"ory Committee on Poliey ha" agrefltl that most book reviews need· not be ~igne
Volume 68
Number 3
BOOK REVIEWS
!151
bomb will fall tomorrow, and harassed by this fear, they do everything to whip their poor bowels into action every morning except to relax on the toilet seat long enough to give them a chance to empty themselves on their own." The main premise of the book is that surgery should be performed for chronic iliac pain only if a definite diagnosis is made. Otherwise patients will be subjected to neerlless surgery, and still retain their pain. Because of the message it carries, young gynecologists and general surgeons would do well to read this book. Les Groupes sanguins chez l'homme. :Etude serologique et genetique. By Jacy_ues Huffie, Assistant Professor, Legal and Occupational Medicine, University of Toulouse. 212 pages. Paris, 1953, Masson & Cie. 1.200 fr. The universal practice of blood transfusion, the problems of fetomaternal immunization, and a variety of medicolegal questions, make the subjects of blood groups one of great practical and theoretical importance. Dr. Ruffie's book is a detailed account of the basic information available on this vast subject. The four major blood groups, the Hhesus, Lewis, MNSs, PQ, and seven other minor systems are examined, and the genetic aspects, statistical analysis, and clinical importance of each are thoroughly discussed. A general introductory chapter on immunization phenomena of the Llood is outstandingly dear and will be of value to anybody who is not particularly well acquainted with these matters. The book contains a discussion of "some elementary principles of the statistics of probability" which is not at all elementary but will help the reader to understand the statistical analysis of each system. When a fundamental problem is discussed, the author gives an ample resume of the major theories involved, such as those of Hirszfeld, Morgan and Watkins, Boorman, Doild, and Gilbey, on the H antigen. · The bibliography is extensive and up to date. The reader will not find here any original contribution, Lut he will benefit from the clarity with which the subject is treated. Lehrbuch der Geburtshilfe. Edited by Prof. Dr. Th. Koller, Basel, Prof. Dr. E. Held, Zurich, and Pro£. Dr. W. Neuweiler, Bern, Switzerland. Second edition. 851 pages with 348 illustrations. Basel, 1953, S. Karger Verlag. Swiss francs 62.40. This volume constitutes the second part of a three-volume text on obstetrics and gynecology. Consequently, it does not embody any description of obstetrical procedures, which are reserved to the third volume. The book is very 'Yell arranged. It contains sections on embryology, normal pregnancy, normal delivery and puerperium, the physiology of the newborn, multiple pregnancy, the pathology of pregnancy, extrauterine gestation, abnormal delivery, complications of the puerperium, monstrosities, and the pathology of the newborn. Each of the different sections has been written by an authority in his field. Altogether, this constitutes a most impressive textbook. The sections on monstrosities and fetal pathology are especially good. These subjects are much more fully covered than is customary in obstetric texts. Roentgen pelvimetry receives scant consideration. The classification of contracted pelvis is based upon etiological factors, rather than morphology. A low-protein diet is advocated in toxemia. Curettage is not performed in incomplete abortion unless all other measures have failed. One of the illustrations in the section on infant resuscitation shows jackknifing of the infant as a means of artificial respiration. With these, as well as some other features, the reviewer would take issue. However, with due allowance for differences in opinion, this remains a thoroug·h ant1 scholarly survey of the field of obstetrics. It may be highly recommended.
952
Am. j. Obst. & Gynec. SePtember, 1954
BOOK REVIEWS
Handbook of Gynaecological Diagnosis. By Walter Neuweiler, M.D., Professor of Midwifery and Gynaecology and Director of the Gynaecological and Obstetrical Clinic in the University of Berne. 4±8 pages with 406 illustrations. New York, 1H52, Grune & 'Stratton. $12.00. As stated in the author's preface, this book is merely a supplement to the many recognized textbooks in gynecology. If the reader will bear this in mind, he will find it of extreme interest. 1'he methods of obtaining a complete gynecological history are aptly explained. They are further enhanced by a careful consideration of such things as constitutional types and symptom complexes. The techniques of performing and interpreting various gynecological examinations are lucidly portrayed and describecl. The section on hysterosalpingography is especially well illustrated. Although the importance of colposcopy in the diagnosis of cervical malignancies is stressed, it is unfortunate that little mention is made of the value or significance of the Papanicolaou smear. Furthermore, in the description and illustration of the lymphatic spread of cervical carcinoma, there is no inclusion of the obturator lymph nodes. In view of the accepted practice of early ambulation in elinics in this country it is interest· ing to read the author's statement that following a uterine curettage the patient "neens at least two to three days' rest in bed." 'fhe author is to be commended for the careful organization of his m~terial and the excellent illustrations. Just as previous texts on differential diagnosis in other branches of medicine have been of value, the Handbook of Gynaecological Dia.gnosis should be a useful guide not only to the medical student but also to the practicing physician in the field of gynecology.
Die Kreuzschmerzen der Frau, Ihre Deutung und Behandlung gynaekologische Orthopaedie. By Dr. Heinrich Martius, Gottingen, Germany. Ji'ourth Improved Edition. 166 pages with 73 black and white illustrations. Stuttgart, 1953, Georg Thieme. DM 19.50. This book covers the twilight zone between gynecology and orthopedics in the very difficult field of low back pain. It is divided into two sections. The first deals with low back pain in women, caused by diseases of the viscera of the true pelvis. The second, and larger portion, concerns itself with low back pain due to changes in the skeleton, the local musculature, and even such culturally determined factors as high heels. The author emphasizes the importance of accurate etiological diagnosis preceding therapeutic intervention and the pitfalls of attempting treatment without adequate diagnosis. Both diagnostic and therapeutic procedures are explained. It is pointed out that the erect posture of man and easy childbirth are opposed to each other and that the skeleton of the human female represents a balance between the two which is easily upset. This volume covers very adequately a field which is of constant interest to the gynecologist and it is well worth his attention.
The Nursing Mother. By Frank H. Richardson, M.D. Prentice-Hall, Inc. $2.95.
204 pages.
New York, 1953,
This small volume is written primarily for the pregnant woman. Although it cannot be denied that breast feeding is to be preferred to bottle feeding, the woman who does not breast feed her infant for any reason should not be condemned to the point whe1·e marked psychological disturbance is produced. This book might well cause this undesired result even though the author occasionally attempts to prevent it. The section devoted to proving that the breast is better than the bottle for feeding infants is not grounded on very good scientific evidence. Infant death rates of one era should not be compared with those of another era unless all factors, not just one such as breast feeding, are considered. The evidence presented is from work done twenty-five to thirty years ago. Inquiry by the reviewer of leading authorities in the field of pediatrics disclosed there are no current authoritative studies that show any difference between the infant mortality rates of bottle-fed and breast-fed infants. There is a higher incidence
Volume 68
Number 3
BOOK REVIEWS
of gastrointestinal disturbances in the secon(l six months of life in the bottle-fed group. The statement that facial development is better in the breast-fed infant than in the bottle-fed infant will be received with skepticism. The author pictures the bottle-fed baby as disregarded by his mother, fed b~- a stranger in strange surroundings, and doomed to permanent psychiatric aberrations. This is by no means a usual occurrence and should provoke some righteous indignation. There are many places in the book where scientific logic is not sound. It is stated that therapeutic abortion is done to save the life of a woman, but then the author states, "Such an interference with nature is attended with more danger than would have been risked had the woman gone on to a full-term delivery.'' Several quotations are given but rarely is the name of the author of the quotation mentioned. Not only is this poor taste, but it also deprives the reader of the authority for the quotation. It is unfortunate that in a book of this type so much emphasis is plared on "natural childbirth," for this might tend to disrupt the relationship between patient and obstetrician if the latter is not an enthusiast for this form of labor. A book of this type is needed in American medical literature to point out the advantages of breast feeding but the criticisms mentioned illustrate weaknesses which may limit its usefulness.
La Sterilita nel maschio. By Guglielmo Longo. 520 pages with 87 illustrations. Naples, 1953, Diffusion Scientiiique Internationale. By far the greatest part (eight-tenths) of the work is dedicated to the normal anatomy and .physiology of the male genital system and to a classification of the various forms of sterility. There is a very exhaustive chapter on clinical and laboratory techniques which includes all the tests more commonly used in the United Statrs and many tests which are rarely used. Therapy is dealt with in one and the smallest chapter, and it is subdivided into: A. 'rreatment of the deficieneies of eoitus; these may be treated according to the etiology of the speciiic case, by (1) hormones, (2) electroshock, electrical cauterization of the nasal mucosa, (3) iniiltration of the hypogastric ganglion and similar procedures, ( 4) psychotherapy (but psychoanalysis is considered "not useful"). B. Treatment of obstructions of the seminal tract; these demand surgical treatment. C. Treatment of the disturbances of spermatogenesis; hypogonadism (deficiency of both the endocrine and the spermatogenic functions) may respond to treatment with gonadotropin. The ability of testosterone to inerease spermatogenesis is open to debate; it has a more deiinite effect in re-establishing the motility of spermatozoa. Dr. Longo's work is essentially a recapitulation of the basic known facts about male sterility. While there is no original contribution to the understanding of the causes, nor any statistical observation sufficiently large to attract attention, the available material has been examined thoroughly and is clearly presented.
Annual Report on the Results of Treatment in Carcinoma of the Uterus, vol. 8. Edited by James Heyman, Stockholm, Sweden. 247 pages.
Stockholm, 1953, Norstedt & Son.
This is the eighth volume of a valuable publication issued approximately annually, and sponsored by The American Caneer Society, The British Empire Campaign, and other prominent institutions concerned with the cancer problem. '!'he editor of the series is Dr. James Heyman of Stockholm, and the plan of each volume is to summarize reports treatment of carcinoma of the female genital tract. Previously, carcinoma of the cervix from leading institutions throughout the western world on the subject of the results of has been the only female genital cancer speciiically reported, and irradiation has been the only method of therapy considered. The scope has iinally been extended in the present report to include carcinoma of the endometrium, and apparently the intention of the future editions is to include summaries dealing with ovarian carcinoma.
954
BOOK H r;V 1E\Y:-;
I Ul"' ,, I Sept~·rni,,,t,
Tho btltt.i,;tie,; J•l'eseuJ<:d in tliio< l'•>lttJr:t 1\ •·rtt l'ulledetl J'n!!u 1;\1 dift'l't(·nt i:;bi i:>:l ,,>tL··, 1:.: of whidt arn ltH·att'd i11 tili:-.. ('Utlutr.'. FJfil'i.'lt difl't•J't'H( t''J!Jfltrit~:-~ un). n·pn·;~P!l!P•i. Tl1,. l'eoultc; L'()VCl' n. total of s:;,:.wJ "/Hit'S of ui•·t'u.: "aremoma. Tltt!J't'
Honnonal Control of the Pelvic Girdle and Sexual Endocrinology.
Hy Mamiee l\larois.
176 pages with J 2 plates. PariB, Hl53, l\[asson & Cie. $2.5!i. An elaborate and comprehensive monogt·aph covering all aspec!B of the problelll of the hypothetical hormone, relaxin, whielt is postulatNl t.u l><: responsible for polvie relaxation in various species has been wJitten by the eodir;;etor of the Laboratory of Experimental Morphology anrl Endocrinolugy of the College of France. The ~tartiug point of this elaborate book iH an exalllination of Hi8aw 's hypothesis that symphyoeal separation in the guinea pig is due to an unidentified hormone, relaxin. Professor Courrier, director of the Laborator:v of Experiment ul 1\lorphology and En,locrinology at the College of ]'ranee, has believed for some time thai. relaxin i~ not :1 ~pedfic substanee, silH>e H is possible to produce s•·paration of the pnl>i<' i>Olll'K in a etn.:trat••
Volume 68
Number 3
BOOK RE'VIEWS
!!55
A great many pages of the monograph are devoted to the tentative exploration of several avenues of approach to the identification of a specific hormone capable of producing symphyseal ligamentary relaxation in the guinea pig. Marois is frank to admit that he has not been able to solve this problem satisfactorily. He has confirmed previous observations that extracts of corpus luteum are capable of producing pubic symphyseal relaxation in the female guinea pig very much more readily than the synergistic action of follicular hormones and progesterone. But the confirmation of the well-known fact that symphyseal relaxation may be produced in these various ways has not been established beyond reasonable doubt, since this would involve the isolation and purification of whatever specific agent is responsible for these hormonal interactions. The major obstacle remains the lack of reliable, eritical biologic tests for assaying the activity of tissue extracts. In summary, this massive monograph, virtually encyclopedic in approach, broadly speculative and imaginatively presented, represents a stocktaking of the present state of our ignorance on this much debated subject. In :Marois' own words: "In spite of the extent of the data already acquired, we are left with more darkness than light. It is hoped that this work will constitute an invitation to further research." Only an elementary knowledge of French syntax is necessary for the reading of Marois' elegantly clear style, a model of its kind. The carefully compiled bibliography makes the monograph an essential item for the library of all investigators of these problems. Le Pneumopatic sufethine del feto e del neonato. By Guiseppe Valle. 54 illustrations. Torino, Italy, 1953, :Minerva Medica.
209 pages with
Dr. Vulle is the director of the Clinic of Obstetrics and Gynecology at the University of Perugia in Italy. In this book he presents an extensive review of the literature relating to pneumonic infections in the fetus and the newborn. In a careful, organized, and scholarly rr_anner he correlates all of this material with his own observations and researches. 'I'here is a complete and exhaustive bibliography. The book is arranged in ten chapters: The first chapter is a historical introduction of the sub;iect. The second chapter deals with classification of the pneumopathias. He proposes his own scheme which divides the sub,iect into three main periods: prenatal, intranatal, and neonatal. These are further broken down into smaller subdivisions with regard to tbe causative agents involved. Subsequent chapters deal chiefly with etiology and pathogenesis. There is an interesting discussion as to the routes infection may take to cause pneumopathia in the fetus, and these are clearly illustrated with diagrams and sketch drawings. Many charts are presented reviewing the organisms involved and the problem of placental transmission. The importance of the aspiration of amniotic fluid by the fetus upon birth, is emphasized, particularly if the membranes were prematurely ruptured and the amniotic fluid infected. The book offers no unusual new theories or solutions, It does, however, serve several important functions. First, it is a good review of the subject matter; second, it suggests several good research problems; third, it alerts the obstetrician to the fact that he is always dealing with two patients, mother and fetus, and that he is responsible for the course and welfare of both; and last, it urges the pediatrician to be more cognizant of the pre-, intra-, and neonatal periods of the infant, so that ultimately his attention may be more effective. Seventy-Five Years of Medical Progress, 1878-1953. Edited by Louis II. Bauer, M.D. 286 pages. Philadelphia, 1954, Lea & Febiger. $4.00. This enlightening book followed the First Western Hemisphere Conference of 'rhe World Medical Association, which was held in Richmond, Virginia, in April, 1953. The object of this conference was to recall the medical progress which has been attained during
956
BOOK REVIEWS
Am.
J. Obst. & Gynec.
September, 195+
the past seventy-five years. The papers were contributed by our most distinguished colleagues in the field of medicine and in the different medical specialties. Each author has endeavored to give a brief review of the history and the distinctive events in his field and to appraise these achievements. It is interesting to obtain this retrospective view of how the various specialties have developed and have become defined. The present extent of our knowledge is also reviewed. The text has not neglected the field of general practice, its role in past progress, and the irnportanee of the general practitioner as a central figure in the care of patients. The book is refreshing as it makes the reader cognizant of the primitive status of medical practice which existed seventy-five years ago. It is thus that we realize that the time, effort, and cost of our present medical organization are well worth while. Pelvic Relaxations and Herniations. By James Wilson, M.D. 64 pages with 35 illustra· tions. Springfield, Ill., 1!l54, Charles C Thomas. $2.75. In this monograph for the American Lecture AerieR, the author points out that the work is designed for students. It first covers the clinical anatomy of the normal female pelvis and then goes on to outline the most important of the pelvic. fascial relaxations and herniations. The etiology of each is considered from an anatomical and physiological viewpoint. No attempt is made to explain in detail the technique of operative procedures but rather the general principles employed are discussed. Adequate reference to the standard operative pro· cedures for each condition is given at the end of each chapter, The work is supplemented with excellent diagrams and drawings which assist in a more complete comprehension of the text. The monograph is concise and complete in its coverage of the pelvic fascial planes and their pathology. Rh-Hr Blood Types. Applications in Clinical and Legal Medicine .and Anthropology. By Alexander S. Wiener, M.D. 763 pages. New York, 1954, Grune & Stratton. $11.50. An Rh-Hr Syllabus. The Types and Their Applications. By Alexander S. Wiener, M.D. 82 pages with 8 illustrations. New York, 1954, Grune & Stratton. $3. 75. Dr. Alexander Wiener, who has long been known as an authority on immunology, particularly in the field of isoimmunization, has written two books on the subject of Rh-Hr blood types. The first is a large compilation of some of the author's most representative and important contributions to the subject. This serves the purpose of placing these documents in one volume with an adequate index of both subject and author. For reasons not clearly discernible the author's total bibliography is also appended. Such a collection of reprints contains much valuable material. All of this is readily available in any good medical library, however, and unfortunately, when conglutinated in this manner, the bias and, at times, uncertain temper of the author are only emphasized rather than tempered with the sound and solid contemplation and revision and revaluation so necessary to fine scientific book writing. It is thus that there is a perpetuation of certain ideas which might be proper for scientific articles of the moment but which on second thought, to ~ay the least, do not come under the heading of proved fact. In such categories are the author's concept of the dual valence of antibodies, his diagrams of the cogwheel characteristics of antibody-antigen reaction, an
\ olume 68 ~umber3
BOOK REVIEWS
!)57
The second volume is a small outline of 82 pages containing a brief but accurate abstraction of much of what is contained in the first volume. Although the errors and bias are still apparent, this volume makes good reading and, if absorbed, will give the reader an intelligent background for further investigation. The article~ in the first volume have been reproduced in a format similar to the ones in which they appeared. 'rhis not only makes for variation in form throughout but in some instances because of the reduction in page size makes for unnecessarily and nearly unreadable type. The paper of this volume is poor. The type and format of the second volume, in contrast, are good throughout. In summary, it is difficult to commend the first of these two works. 'l'he Rh problem, as such, ha.s been overemphasized because of its clinical significance. In reality it differs neither in complexity nor in concept from the entire problem of erythrocyte antigenicity. On this a broad text soundly and judiciously conceived would have been more to the point.
Obstetrical Pathology. By Dr. Jose Botella Llusia. (j\J!:J pages with 434 illustrationH. Madrid, 1953, Cientrifico-Medica. Dr. Jose Botella Llusia is Professor of Obstetrics and Gynecology at the University of Medicine in Madrid. He has written and published four books, which comprise his complete course in the elements of obstetrics and gynecology, of which this title is one. The other three books are entitled Female Physiology, Obstetrics, and Diseases of the Female Tract. The book is divided into three main parts: the pathology of pregnancy, the pathology of parturition, and the pathology of the puerperium. These are further subdivided into 40 chapters, which cover comprehensively all the subjects of pathological significance relating to the subject of obstetrics. 'rhe book is unique in that it is a wellorganized and convenient text dealing only with obstetrical pathology. Most of the subjects are dealt with at great length and in great detail. '!'he 434 illustrations consist of diagrammatic sketches, photographs, and color photomicrographs. In general, the author's theories and teachings are in agreement with the universally aecepted ones. In discussing the toxemias, the author rejects the classification of pre-eclampsia and eclampsia as two separate diseases. He firmly believes they are one and the same, varying only in intensity and severity. He remarks on the apparent declining incidence of the disease in Spain, and relates this to better prenatal care and better nutrition. His preferred plan of treatment is as follows: morphine sedation, inhalation of 5 per cent oxygen with 20 per cent carbon dioxide, administration of hypertonic glucose and intramuscular magnesium sulfate. The author's comprehensive discussion of all the complications of pregnancy includes, besides the usually discussed ones, various liver dysfunctions, cholecystitis and cholelithiasis, appendicitis, mouth lesions, hernias, dyspepia, peptic ulcers, and intestinal colic. Many of Dr. Llusia's statements are quite positive, indeed interesting, although there is a definite lack of reference support. For instance, he says that gastric ulcer is rare in pregnant patients for three reasons: ( 1) there is less gastric acidity; ( 2) elevation of the stomach by the pregnant uterus lessens its distention and better vascular circulation results; ( 3) the increased estrogen enhances better healing of the gastric mucosa. The subject of cardiac complications is dealt with extensively. It is his opinion that repeated pregnancies in a cardiac patient, if well handled, do not affect deleteriously the cardiac status, general health, and longevity of the patient. The subject of abortion is thoroughly discussed along with the problem of criminal abortion. The author speculates that there are 50,000 criminal abortions performed annually in Spain. In the Madrid Maternity Hospital there were 18,000 babies born in the years from 1939 to Hl49, and 4,800 abortions. The author assumes that 10 per cent of all births should result in spontaneous abortion and that the remainder would be criminally induced. The mortality rate for abortions in this period was 3.6 per cent. G~nital
Mn.
J. Obst. & < Sept·.~n:~)k',_
The subject of dysioci:t i,; parti<·ularly 11c'!l organized nud \'.ompletely •.:<>V<.'n•d. The hook has no bi!Jiiograph;y. The lad, nl' hihliography awl. ref.,l'<'ll<'"' ii111.l ri"· :t.r·Jac· of loo$e r(·asonil
Books Received 'l'he following books have been n'''eivt!d and select,;d roviews will appear in !att•r issues. rrFCLE
PUBLISHER
d Caneer Ginecologieo
Juan Carluo; Ahumada ( 'olaborfldor<'~
y
1<:1 Ateneo, Buenos Ain's
'fhe Digestive Tract in Roent· genology i::lccond edition
,J. B. Lippincott Co., Phila· <1elphia. $30.00
Grundlagen und Ergebenissc dcr Bulfonamidanwendung gegen Karzinomstreptokok ken
Ueorg 'l'hi;•me, DM 21
The Hypertensive Disorders of Pregnancy
Ernest Pag"
Hesuscitatiou of the Newborn
.T oscph
Crtncer of the Female Genital 'l'ract
Herbert F. Traut and Ralph
Erythroblastosis Fetalis, Re· port of the Sevt'nth M & H Pediatric Research Confer·
Charl(lS .Janeway, Chairman
Charles C Thomas, Spring· field, Ill.
C.
Rus~
Leipzig.
$3.75
Charles C 'l'homas, Spring· field .• Ill. $2.50 Davi~,
Bf'n~on
Delaney, lne., New
York
!\I & H Laboratories, Colnm· lou~,
Ohio
enee
:\I('uorrhalgia· Menstrual tress
i ~harles
Proceedings of the Society for the Study of Fertilit~· Nnmher V, HJ5:!
IV.
'l'he Intimate Women
ProhlPm~
C Thomas, Spring· $2.75
field, lll.
of
lleffer
&
<~ambridge,
Henry B. Hafford
Hawthorne
NPw Ymk
Sons, Lt1L, England
Books, $!1.95
Die Variationsmoglichkeiten im Aufbau der Uterusschleimhaut in den einzelnen Phasen des Mensuellen
Heinz Behrens
Georg 'l'hieme.
A la Hecherche cl'une ethiqne m(>dicale
Louis Port<'s
Ma~Hon
Din Viruskrankheiten in der Gyniikologie und Geburt·
Meta Sander
shilfe
OM 9.60
& C:ie, PariR.
fr. Georg Thieme
Ine.,
800